|Job Title:||Care Manager Nurse (RN),|
|Area of Interest:||Nursing|
|City:||Los Angeles - 90012-2104|
|Positon Type:||Full Time - Regular|
|Overview:||The Nurse Care Manager will provide case management to patients who may need to be enrolled in ambulatory care management. Responsible for the allocation of Level of Care Certification to the patient. Works as part of an interdisciplinary care team coordinating social work and mental health counseling, psycho-social support services, in-home support, legal services, skilled nursing, home health, etc. The Nurse Care Manager effectively collaborates with the hospitalist, the hospital nursing personnel, with members of the interdisciplinary care team and with the patient’s physician in the community. Must be able to apply critical thinking skills and make sound judgment at all levels throughout the patient’s continuum of care.|
1. Responsible for daily concurrent reviews, retro reviews, discharge planning, and ensures patients meet appropriate level of care based on acceptable evidence-based clinical criteria.
2. Effectively and efficiently manages patients throughout the continuum of care.
3. Works collaboratively with Hospitalists, hospital partners, hospital case managers, health plan, clinics, and other governing entities to provide holistic patient care that is focused on high quality in a cost effective way.
4. Will participate in the developing of all program material, policies and procedures related to the nurse case management program.
5. Creates program manuals and quality management policies.
6. Develops program informational and educational materials and various forms.
7. Identifies and enrolls patients into a care management program providing intensive service.
8. Conducts intakes and comprehensive assessments per health plan and department’s policy.
9. Identifies needs and develops individualized care service plans on behalf of clients.
10. Responsible for being an active participant in Case Conferences and attends Divisional Coordinators meetings.
11. Re-evaluates patients as needed and monitors the services delivered by team participants.
12. Works with hospital discharge planners and assists in the coordination of support services.
13. Attends Joint Operation Committee (JOC) meetings and various community meetings as needed.
14. Performs other related duties as assigned.
|Skills and Abilities:|
1. Excellent customer service skills and ability to resolve complex customer service issues and exercise conflict management.
2. Ability to read, write and speak in a clear, accurate and professional manner; includes active listening skills and understanding medical terminology.
3. Ability to complete basic/intermediate math computations and medical math conversions.
4. Proficient in beginning/intermediate computer skills and typing.
5. Excellent follow through skills, multi-tasking, prioritization and attention to detail.
6. Must be able to apply critical thinking skills and make sound judgment at all levels throughout the patient’s continuum of care and make necessary referrals on behalf of P/P/C (Patient/Provider/Caregiver).
7. Knowledge of regulatory requirement, health plan contracts, governmental benefits and community resources.
1. Graduation from an accredited nursing program.
2. Current valid License as a Registered Nurse through the California Board of Registered Nursing.
3. Current CPR/First Aid training required.
4. Experience with physically or mentally impaired adults and/or geriatric population and working as part of a multi-disciplinary team.
5. Minimum of one year experience in geriatrics and/or care management required; in home-health care strongly preferred.
6. Bilingual in English and Spanish preferred.